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Organization

DOMUS CARE SOLUTIONS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAFAEL OSVALDO HERNANDEZ LORA MD (OWNER/PHYSICIAN)
(718) 406-4896
Entity
Organization

Contact information

Practice address
2200 N COMMERCE PKWY STE 200, WESTON, FL 33326-3258
(718) 406-4896
(954) 529-2001
Mailing address
2200 N COMMERCE PKWY STE 200, WESTON, FL 33326-3258

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
IHBP9
FLORIDABLUE
FL
Enumeration date
01/21/2020
Last updated
01/21/2020
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